Provider Demographics
NPI:1407005291
Name:SHAW, JENNIFER ROBIN (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ROBIN
Last Name:SHAW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 SHERWOOD RD
Mailing Address - Street 2:
Mailing Address - City:SHORT HILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07078-2069
Mailing Address - Country:US
Mailing Address - Phone:973-376-0202
Mailing Address - Fax:973-218-1347
Practice Address - Street 1:7 SHORT HILLS AVE
Practice Address - Street 2:
Practice Address - City:SHORT HILLS
Practice Address - State:NJ
Practice Address - Zip Code:07078-2504
Practice Address - Country:US
Practice Address - Phone:973-376-0202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA076796002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry